Battle plan for bird flu pandemic

When the expected bird flu pandemic hits the world, New Zealand's borders will be closed, public gatherings banned and interisland travel may be stopped in a bid to control what may be the worst public health emergency since 1918.

No one knows when the next global influenza epidemic will strike, but health experts fear it could be caused by the bird flu virus that has killed 64 people in Asia. It has led to the culling of millions of birds, mainly in Asia, but has also been reported in birds in several European countries.

The H5N1 virus cannot yet spread easily between people, but the World Health Organisation fears it will mutate into a new pandemic strain that could kill 2 million to 7.4 million people worldwide.

Health Minister Pete Hodgson yesterday released the Government's battle plan to control an influenza pandemic. It aims initially to keep the disease out of New Zealand, then to stamp out the first clusters of cases within the country, to manage the outbreak once it is more widespread, then to recover from the devastation.

"New Zealand can pride itself on being better prepared than most countries," Mr Hodgson said. "However...until we have a pandemic virus, we simply don't know how it will affect people."

The 1918-19 Spanish flu infected 40 per cent of New Zealand's population and killed about 8000.

If a bird flu pandemic equally virulent and novel to the human immune system struck the country, it could infect about 1.6 million people - 40 per cent of the population - and kill 33,000 in an eight-week period.

In the darkest week, 10,000 would die. In normal times, 550 people die a week.

In this grim worst-case scenario, undertakers would be unable to cope and some bodies might have to be frozen in shipping containers.

Nationally, 200 children could be orphaned. The parents of a further 800 might be in hospital, forced to rely on others to care for their children.

At the height of an epidemic, with the flu spreading easily in the community, hospitals and health clinics would be unable to cope. Community assessment and treatment centres would be set up to administer Tamiflu anti-viral medicine tothose permitted to have it.

All but the seriously ill would have to be cared for at home, with hospital beds reserved for the most severe cases.

Hotels and community centres may be used for outpatients or inpatients who have been discharged from hospital.

Mr Hodgson said some changes were likely to be needed to cover gaps in health-emergency law. He hoped to take papers to the Cabinet before Christmas.

For instance, officials could quarantine people with flu, but it appeared that they could not quarantine those suspected of having it.

He said this was "exactly the point at which you do want to hold them, so that it is less likely to spread and you can get them treated".

The plan urges district health boards to stockpile Tamiflu, in addition to the Government's store of about 850,000 courses, enough for a fifth of the population.

The Health Ministry's director of public health, Dr Mark Jacobs, said he understood some boards had already acquired Tamiflu. Who would receive the Government's stock would not be decided until a pandemic began.

He said one of the aims of the plan was to keep the virus out of the country as long as possible so people could be offered vaccination.

New Zealand had struck a deal with an Australian vaccine maker and was third in line after Australia and another country Dr Jacobs would not name.

The contract provided for about 8 million vaccine doses - enough for everyone to have two - to be delivered between 15 and 27 weeks after the recognition of a pandemic and the placing of New Zealand's order.

Greens health spokeswoman Sue Kedgley, who in June labelled New Zealand inadequately prepared for bird flu, said last night: "They have done a lot since."

But "New Zealanders need to know and prepare for the fact that the message is that most of us will have to look after ourselves".

- Additional reporting, Ruth Berry